Recent tragic events in the Elliot Hospital emergency department, where hospital employees were injured by patients awaiting admission to New Hampshire Hospital, should serve as a call to action here in New Hampshire.
The growing crisis of patients suffering from a mental illness who are forced to wait days, sometimes weeks, to get the specialized care they need at New Hampshire Hospital is unfortunately becoming all too well known here in the Granite State. It’s not uncommon on any given day for more than two dozen patients to be waiting in hospital emergency departments around the state for admission to New Hampshire Hospital. In fact, early last month, that number climbed to 49 adults and three children. And, historically, the number of mental health patients needing the specialized care that is provided at New Hampshire Hospital has traditionally grown as winter approaches.
The effect of this failure of the mental health system in New Hampshire amounts to a major, measurable and urgent public health crisis that needs immediate attention.
The impact is that adults and children are confined in hospital emergency departments that are not designed or staffed for psychiatric care as they await transfer to New Hampshire Hospital. These waiting times can last for days or weeks. Lengthy delays for care at the time of a mental health crisis — often in a confined and isolated setting — can be frightening, stressful and can cause the individual’s underlying condition to worsen. It is frustrating and stressful for family members and health care professionals; also, the need to justify this type of confinement is creating issues of justice and proper protection of individual rights.
The stress that this situation is causing on hospital personnel and the drain put on emergency room resources is quite troublesome. Clearly, these were the type of situations that helped amplify the need to establish the budget priority of investing in the Ten-Year Mental Health Plan, beginning in July of 2013, for which the governor and the Legislature should be proud. However, while investments in the 10-year plan made in the budget will eventually help address structural deficiencies in the state’s community mental health system, many of those investments are weeks, months or years away from addressing the immediate problem.
It would appear that some type of bridging effort is needed to stabilize the system until the impacts of this year’s budget investments can be realized.
All of the factors that are contributing to this rapid increase in the admitting queue are not yet clear. From both the community mental health centers’ and the local hospitals’ vantage points, we are able to identify some contributing factors, but we believe that a more comprehensive and rapid review of this public health situation needs to be undertaken.
We understand that the governor and DHHS leadership are well aware of this situation and are working on trying to find a solution. As stakeholders, clearly we support this action and given the level of urgency, we urge that it advance as soon as possible.
The nature of this mental health crisis and its impact on the state requires that we:
• Analyze its cause and devise short-term and medium-term bridging strategies to alleviate the New Hampshire Hospital backups;
• Avoid what could be more dangerous outcomes, and;
• Provide more immediate care for those in a mental health crisis.
The time to act is now, before yet another tragic event occurs.
Steve Ahnen is president of the New Hampshire Hospital Association. Jay Couture is president of the New Hampshire Community Behavioral Health Association.